Primary solitary mediastinal mass lesions: a review of 37 cases.

Background: Primary solitary mass lesions of the mediastinum, although relatively uncommon, encompass an interesting spectrum of pathologies.

Methods: A comprehensive retrospective review was undertaken of all cases of mediastinal lesions that presented to the two major thoracic surgical centres in North Queensland, Australia, over a 7-year period.

Results: Thirty-seven mediastinal mass lesions were managed over the period of the review. Over one-quarter of all cases were clinically silent, the pathology having been discovered incidentally during investigation for other reasons. Malignant thymoma was the single most common pathology, being present in 13 (35.1%) cases. A variety of other pathologies were encountered, including thymic cyst, bronchogenic cyst, neurofibroma, parathyroid adenoma, and lymphoma. Expeditious surgical resection of the lesions, once discovered, afforded good medium-term survival, even for those patients with malignant pathology.

Conclusions: Prompt thoracic surgical referral with view to aggressive, early resection optimizes clinical outcome in the short and medium-term for patients presenting with mass lesions of the mediastinum.